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Biomedical subjects

B van Damme

Publications and source records attributed to B van Damme.

At least 19 recordsLinked to original sources

Malignant angiomyolipoma of the liver: a hitherto unreported variant.

AIMS: After their original recognition in the kidney, angiomyolipomas (AMLs) have been reported in the liver for more than 20 years. In the kidney, five cases of malignant AML have been reported. We report the first case of malignant hepatic AML. METHODS AND RESULTS: A 70-year-old female patient presented with abdominal discomfort. Clinical examination revealed a palpable liver. CT scan showed a polymorphous hypervascular lesion in the right liver lobe. A biopsy was taken and resulted initially in a differential diagnosis between a hepatocellular carcinoma, a metastatic tumour (possibly of renal origin) and angiomyolipoma (AML). After immunohistochemistry, a hepatic AML was suggested, given the immunoreactivity for HMB45/NKIC-3. The mass was resected 5 years later because of relapsing abscess formation. Gross examination of the resection specimen showed a focally encapsulated brown mass with focal necrosis. Microscopic examination showed a tumour growing in sheets, separated by sinusoidal-like vessels. Most of the tumour cells had a large, polygonal, clear cytoplasm, often with eosinophilic condensation around the nucleus. There was prominent vascular invasion. Immunohistochemistry (reactivity for HMB-45, NKIC-3, S100 and alpha smooth muscle actin, negativity for cytokeratin and vimentin) and electron microscopy confirmed the diagnosis of monomorphic epithelioid AML with prominent vascular invasion. Seven months after tumour resection, the patient died of recurrent disease. CONCLUSIONS: This case highlights the importance of immunohistochemistry and electron microscopy in diagnosing this type of tumour. Possibly, in the past, malignant AML of the liver has been misdiagnosed as HCC.

Actins↗

Cytogenetic investigation of synchronous bilateral renal tumors.

Cytogenetic investigations on synchronous bilateral renal tumors are scarce. We report our findings on 13 renal tumors from 5 patients and review the literature. In bilateral as well as in solitary tumors, cytogenetic findings in each tumor correlated with the histological patterns, i.e. combinations of trisomies for papillary renal cell carcinoma, loss of 3p-material for non-papillary renal cell carcinoma, and coincident loss of the Y chromosome and chromosome 1 in oncocytomas. Bilateral multifocal renal cell carcinomas were always of the papillary type and the karyotypes showed more or less the same numerical anomalies, with trisomies in different combinations in tumors within the same kidney as well as in both kidneys. Structural changes, in contrast, were different from tumor to tumor.

Aged↗

Giant cell rich parosteal osteosarcoma.

A parosteal osteosarcoma of the distal femur with a typical radiographic and macroscopic appearance is reported. On histology the tumour was dominated by large numbers of osteoclast-like giant cells in a fibro-osseous background and islands of immature bone. Most of the neoplastic bone lacked osteoblastic rimming. There was no spatial relationship between the giant cells and areas of haemorrhage. Signs of 'dedifferentiation' were lacking. Cytogenetic a analysis revealed telomeric associations which are frequently found in giant cell tumours of bone. Parosteal osteosarcoma may, on histological appearances, hardly be recognizable as malignant. In addition, unusual changes such as abundant giant cells may be misleading in the absence of clinico-pathological correlation.

Adult↗

Chromosome aberrations in fibrous dysplasia.

We report the cytogenetic findings of two cases of fibrous dysplasia, one occurring in the tibia, the other in the sphenoid. Both cases exhibited only one chromosome change: a t(6;11)(q15;p15) in the first case, a derivative chromosome 2 in the second. The previous cytogenetic report on fibrous dysplasia revealed only numerical changes. The significance of these inconsistent chromosomal findings in fibrous dysplasia is unclear.

Adult↗

Partial prevention of active Heymann nephritis by 1 alpha, 25 dihydroxyvitamin D3.

The hormone 1 alpha, 25 dihydroxyvitamin D3 (1,25(OH)2D3) has potent immunosuppressive effects in vitro. Recent publications also described a protective effect of the hormone in various animal models of immune-mediated diseases. To test its in vivo activity we induced active Heymann nephritis in Lewis rats that were either untreated or treated with 1,25(OH)2D3 or its synthetic 20-epi analogue, KH1060. Treatment with cyclosporine A (CsA) was used as an immunosuppressive control. In this nephrotic model the administration of 1,25(OH)2D3 (0.5 microgram/kg body weight) given on alternate days during the first 13 days after active immunization significantly reduced the proteinuria as measured by weeks 7-9. This reduction was comparable to the reduction observed in rats treated with CsA (20 mg/kg) on alternate days. A second series of experiments with 1,25(OH)2D3 confirmed these findings. The level of autoantibodies was found to be significantly suppressed during the treatment time in the CsA (20 mg/kg) group, whereas the limit of significance (P = 0.06) was reached in the 1,25(OH)2D3 (0.5 microgram/kg) group. The size of the immune deposits also was found to be substantially smaller in the groups that developed less proteinuria. The administration of 1,25(OH)2D3 transiently increased the mean serum calcium concentration with 2.5 mg/dl above the pretreatment values, and the urinary calcium excretion by a factor of 3-5 during the short treatment time. Treatment with the analogue KH1060 did not reduce the proteinuria significantly. Our experiments add evidence to the hypothesis that 1,25(OH)2D3 in pharmacological doses has immunosuppressive potency.

Animals↗

Xanthogranulomatous pyelonephritis in a child.

Xanthogranulomatous pyelonephritis is an uncommon form of chronic aggressive infection of the kidney and surrounding tissues usually affecting middle aged women. It is rarely seen in childhood. We report the case of a female child with a history of fatigue, progressive anorexia, and fever in whom a diagnosis of pyelonephritis on a predisposing factor of lithiasis was suggested. After initial antibiotic treatment, nephrectomy was needed for an acute general deterioration. Pathology demonstrated xanthogranulomatous pyelonephritis.

Child, Preschool↗

Magnetic resonance imaging, microangiography, and histology in a rat model of primary liver cancer.

RATIONALE AND OBJECTIVES: N-nitrosodiethylamine is able to induce various benign and malignant liver lesions in rats with a high success rate and a low mortality rate. It provides a more appropriate model that better simulates the various lesions occurring in patients than the usual model of tumor implantations. METHODS: Hepatic carcinogenesis was induced in 58 Wistar rats using oral N-nitrosodiethylamine. The rats subsequently were studied by liver magnetic resonance imaging (MRI), postmortem microangiography, and histologic examination. RESULTS: Hepatic tumors developed in 57 rats. A wide variety of the tumors in the degree of vascularization, the type of vessels, the areas of intratumoral secretion and necrosis, and the tumor cell differentiation resulted from the tumor model. The authors were able to assess the contribution of the vascular, extravascular, and cellular components in the final pattern of contrast enhancement in MRI. CONCLUSIONS: The N-nitrosoethylamine model for hepatic tumor induction is simple, and provides a more representative range of tumors for experimental evaluation.

Animals↗

Renal transplantation in 20 children with hemolytic-uremic syndrome.

In this study the outcome of kidney transplantation in 20 patients with end-stage renal disease (ESRD) due to the hemolytic uremic syndrome (HUS) was evaluated. The characteristics and severity of the primary disease in these patients were not different from those commonly reported in patients with HUS. Eleven children developed ESRD immediately following HUS, in nine others temporary partial recovery of kidney function for 0.5-13.2 years was observed. Twenty-four grafts were transplanted in these 20 patients. Graft survival was no different from overall cadaver graft survival. In nine patients failure of the first kidney graft occurred, while the four second grafts were still functioning at the time of writing. Recurrence of HUS was suspected but not proven to be the cause of first graft failure in two patients, and impaired graft function in a third one. A short interval between HUS and kidney transplantation seems to adversely affect graft survival. No other factors influencing outcome of transplantation could be detected.

Child↗

[IgA-nephropathy in childhood].

IgA nephropathy or M. Berger is regularly diagnosed in childhood. A kidney biopsy is necessary to verify the diagnosis, by demonstrating deposition of IgA in the glomerular mesangium. The kidney biopsy is performed in cases of recurrent macroscopic haematuria or persistence of microscopic haematuria, with or without proteinuria. The prognosis and factors influencing the prognosis in childhood IgA nephropathy are uncertain. In a mainly retrospective study we tried to find correlations between clinical and histological findings and the outcome after a mean follow up period of 7.36 years in 56 patients. In this study with its restrictions it was impossible to find correlations between histological parameters and outcome on one side and between sex, hypertension, macroscopic c.q. microscopic haematuria, proteinuria and outcome on the other hand.

Adolescent↗

The significance of perineural spread in adenoid cystic carcinoma of the major and minor salivary glands.

Patient survival, local recurrence and distant metastasis were studied in relation to the pathological finding of perineural spread in 37 patients with adenoid cystic carcinoma of the major and minor salivary glands. All patients underwent a combined surgical and radiotherapeutical treatment. The overall incidence of perineural invasion in primary resection specimens was 52.6%. The 5-year actuarial survival rate for patients with perineural invasion was significantly lower (p less than 0.001) than for those without (36.9% versus 93.8%). In 26 patients with resection margins free of tumour, recurrences developed in 9/11 (81.8%) of the patients with perineural invasion as opposed to 4/15 (26.7%) of the patients without perineural invasion (p = 0.005). In the same group with resection margins free of tumour, distant metastasis developed after the primary treatment in 4/10 (40.0%) of the patients with perineural invasion, while none of the 14 patients without perineural invasion experienced distant metastasis (p less than 0.0002). The incidence of perineural invasion increased with a higher stage of the primary tumour.

Adult↗

Sicca syndrome with iron deposition in the salivary glands.

A case of iron deposition in the labial accessory salivary glands associated with prominent xerostomy and xerophtalmy is reported. Suffering from a myelodysplastic syndrome with refractory anaemia, this patient received multiple transfusions over the past 7 years. A transfusional haemosiderosis gradually developed. Histopathologic examination of accessory salivary glands demonstrated haemosiderin deposition in the serous alveoli and in the epithelial cells of intercalated and interlobular ducts. A relationship between the iron deposition in the salivary glands and the development of the sicca syndrome is suggested. The literature related to iron deposition in salivary glands and sicca syndrome is reviewed.

Anemia, Refractory↗

Keratin immunohistochemistry in normal human liver. Cytokeratin pattern of hepatocytes, bile ducts and acinar gradient.

A panel of 2 polyclonal and 7 monoclonal antibodies directed against cytokeratins was tested on cryostat and paraffin sections of 14 normal human liver biopsies using an immunoperoxidase procedure. The staining characteristics of hepatocytes and bile ducts are reported. On cryostat sections, monoclonal antibodies directed against individual cytokeratins no. 8 and no. 18 stained both bile ducts and hepatocytes, whereas monoclonals anti-cytokeratin no. 7 and no. 19 exclusively stained bile ducts. The potential use of these 4 monoclonal antibodies in liver histopathology is briefly discussed. Monoclonal antibody anti-type II cytokeratins and the polyclonal rabbit anti-human keratin stained only bile ducts on both cryostat and paraffin sections. Using monoclonal antibody CAM 5.2 on paraffin sections, both bile ducts and parenchyma were positive. An acinar gradient was apparent in that zone 1 hepatocytes were more intensely stained. Moreover, a rim of hepatocytes around terminal hepatic venules and adjacent to subhepatic veins showed more intense staining. The same gradient could be seen in some paraffin sections stained with the monoclonals anti-cytokeratin no. 18 and KL1, and the rabbit polyclonal anti-keratin "wide spectrum screening". The gradient is interpreted as reflecting quantitative differences in keratin content between hepatocytes. Polyclonal rabbit anti-human keratin is proposed as the most reliable antibody for identification of bile ducts in paraffin sections. The usefulness of reliable bile duct staining in several pathological conditions is emphasized.

Antibodies, Monoclonal↗

Ketoconazole-induced hepatitis: a case with a definite cause-effect relationship.

We present the case of a female patient in whom acute hepatitis developed after 180 days of ketoconazole administration (200 mg/day). A prompt renewed hepatic injury after an unintentional rechallenge 6 months later provided definitive evidence for a causative relationship between ketoconazole and acute liver disease. The clinical and biochemical parameters of the case are reported. Histological examination revealed the picture of acute hepatitis with possible transition to chronicity. A prominent accumulation of perisinusoidal lipocytes (Ito cells) was observed.

Acute Disease↗

Primary neoplasm of the ureter: a review of twenty-eight cases.

Twenty-eight patients with primary ureteral neoplasms of which 7 of a benign type were reviewed retrospectively. Sixteen of these patients underwent segmental resection, with a 2-year survival of 81% and with no ureteral recurrence. Eleven other patients underwent a complete nephroureterectomy with bladder cuff excision with a subsequent 2-year survival of 63.6%. We believe that segmental resection is indicated in all low-grade and low-stage lesions and with a small chance of recurrence.

Carcinoma, Transitional Cell↗

Subperiosteal juxta-articular osteoid osteoma.

Subperiosteal osteoid osteoma in a juxta-articular site presents a diagnostic challenge. The clinical features of joint stiffness, synovitis, muscle atrophy and local warmth may suggest arthritis rather than osteoid osteoma, while radiographs, bone scans and angiograms may not be diagnostic. We describe four cases of this rare condition.

Adult↗